DESCRIPTION (Taken from the applicant's abstract): Systemic lupus erythematosus (SLE) is the prototypic systemic inflammatory autoimmune disease that affects predominantly young premenopausal women. African-American women are afflicted 3 to 4 times more frequently than Caucasian women. A major focus of the candidate's research has been in the study of 1) long-term consequences of SLE including, premature cardiovascular disease, osteoporosis and malignancy, and 2) interventions to improve quality of life. The major thrust of this application will be to further develop a strong research program examining the role of inflammation and autoimmunity on cardiovascular disease in SLE. SLE is unique in that young premenopausal women are at substantially increased risk of myocardial infarction and stroke. Several potential mechanisms exist for ischemia, such as overt vasculitis, vasospasm, microvascular disease, or thrombosis with or without atherosclerosis. We do not know the burden of atherosclerosis in SLE, the most predictive risk factors, or whether there are important racial influences. In addition to traditional factors, inflammatory, immunologic, and treatment-related factors specific to SLE are likely involved. With the support of the Mid-Career Investigator Award, the candidate will work with a multidisciplinary team of established investigators and trainees in the areas of vascular imaging, cardiovascular epidemiology, biostatistics and risk-factor measurements including, inflammatory markers and autoantibodies. This collaborative effort will provide important information regarding prevalence and extent of subclinical vascular disease and associated risk factors in SLE. More far reaching is that SLE may be an ideal experiment of nature in which to further examine the role of inflammation and immune mechanisms in atherogenesis.